CVS Health and Safety (Personal Evac Plan)

Name of Visitor

Visitor Contact Telephone Number

Format: 00000 000000.

Next of Kin Name

Next of Kin Telephone

Format: 00000 000000.

Date and Time of Visit

Date

Hour MinutesAM/PM Option

Primary location/room of visitor during their visit.

Name of Professional, Carer or Buddy supporting the visit.

Nature of Condition

Preferred method of Fire Evacuation Notification

Other

Preferred method of evacuation in the event of an emergency.

Other

Please provide any further details that may enable us to provide the most effective support for the visitor.

VISITOR FIRE EVACUATION PROCEDURE

The evacuation procedure is a step-by-step account beginning from the first alarm. Complete the blanks or delete as appropriate to complete the procedure below:

STEP 1 - Once the building evacuation alarm is activated the visitor should be alerted immediately, and calmly, to the need to evacuate. If the visitor requires a prompt, please name the person who will have responsibility to alert the visitor to the need to evacuate below (if the visitor does not require a prompt, please leave blank):

STEP 2 - Evacuate using the nearest designated emergency exit (Main Stairwell or Emergency Stairs located in Kitchen). DO NOT USE THE LIFT.

STEP 3 - Proceed carefully to the designated evacuation meeting point at the front of the buiding. PLEASE LEAVE BEHIND ANY BELONGINGS OR EQUIPMENT.

Where the visitor requires assitance please ensure they are positioned at one of the designated rescue points. These are the top of the main stairwell or the kitchen emergency exit platform.

STEP 4 - Report to the Fire Marshall or the designated assistant and advise if the visitor is located at one of the designated rescue points awaiting assiatance.

STEP 5 - Alarm Ceases - await further instructions from the Fire Marshall. DO NOT RE-ENTER THE BUIDLING UNLESS INSTRUCTED IT IS SAFE TO DO SO.

Please Note: The intended exit route and stairs may need to change depending on the location of the fire. Consider what actions or considerations may need to be implemented if the chosen route is not accessible.

CVS Health and Safety

Community Voluntary Support: Fire Emergency Evacuation Plan and the Fire Procedure (FEEP) Date Created / Reviewed: 01/03/2023

Date to Review: 01/03/2024 (Or as required)